NANDA-I 2024-2026 edition · Reviewed November 2, 2026 by the editorial team
Diagnosis at a glance
| Code | 00435 |
|---|---|
| Label | Inadequate health knowledge |
| Before (2021-2023) | Former code 00126 |
| Spanish label | Conocimientos de salud inadecuados |
| Domain | 5. Perception / cognition |
| Class | 4. Cognition |
| Type | Problem-focused |
| Status | Current |
What changed in 2024-2026
The label changed from "Deficient Knowledge" to "Inadequate Health Knowledge," and the code from 00126 to 00435. If your materials are from the previous edition, you will see 00126; for new assignments, use 00435. As before, it is best to specify the topic: "regarding insulin management," "regarding a low-sodium diet."
What it means
The patient does not know enough about their illness, their treatment or how to care for themselves, or holds misconceptions that put them at risk. It is not a lack of ability: it is information they are missing, did not understand or do not know how to apply.
Explanation written by our team. The official definition is in the NANDA-I 2024-2026 book.
When to use it
Clinical situations where it commonly shows up. The diagnosis is confirmed by your assessment, not by the medical diagnosis.
- Recent diagnosis of a chronic illness: diabetes, hypertension, heart failure.
- Starting a new treatment: insulin, anticoagulants, inhalers, dialysis.
- Hospital discharge with home care needs: wounds, tubes, ostomies, oxygen.
- Readmissions for the same problem that suggest the patient does not know how to manage their illness.
- Beliefs or information from the internet that contradict the treatment plan.
- First pregnancy or caring for a newborn.
What to assess
- What the patient knows: ask them to explain their illness and treatment in their own words.
- What they want to know and what worries them.
- Education level, reading level, primary language, and whether they need an interpreter.
- Vision, hearing, memory and alertness that may limit learning.
- How they learn best: reading, watching, hands-on practice.
- Who supports them at home and who else should receive the teaching.
- Errors in practice: how they inject insulin, how they use the inhaler, what they eat.
Defining characteristics
Assessment findings that support the diagnosis. They go in the "as evidenced by" part of the statement.
- Cannot explain in their own words what illness they have or what their treatment is for.
- Makes errors when demonstrating a technique: insulin, inhaler, wound care.
- Takes medications at times or doses different from those prescribed.
- Asks questions or makes comments that reveal misinformation.
- Follows advice from relatives or social media that contradicts the treatment plan.
- Does not recognize the warning signs of their illness.
- Is readmitted or goes to the emergency department for preventable complications.
- States that nobody explained things to them or that they did not understand what they were told.
Related factors
The causes nursing can act on. They go in the "related to" part of the statement.
- Information given in technical terms the patient does not understand.
- Explanations given only once, in a rush or on the day of discharge.
- Written materials that do not match their reading level or language.
- Anxiety or pain at the time of teaching.
- No opportunity to practice the technique under supervision.
- Conflicting information from different sources.
- Little interest in learning because they do not connect the treatment with their well-being.
At-risk populations
- People recently diagnosed with a chronic illness.
- Older adults with vision or hearing deficits.
- People with limited formal education or limited proficiency in the language of care.
- Family caregivers taking on care at home.
- First-time parents.
Associated conditions
- Diabetes mellitus.
- Heart failure.
- Hypertension.
- COPD and asthma.
- Anticoagulant therapy.
- Surgery requiring follow-up care at home.
How to write it (PES)
Inadequate Health Knowledge regarding insulin management related to information given in technical terms without supervised practice as evidenced by incorrect injection technique on return demonstration, inability to identify symptoms of hypoglycemia, and stating that they skip the dose when they do not eat.
Inadequate Health Knowledge (00435), specifying the topic.
Why the patient does not know: how they received the information, language or reading barriers, anxiety, lack of practice. Avoid "related to lack of information," which just restates the problem.
What the patient said or demonstrated: what they could not explain, what they did wrong in the technique, what misconceptions they expressed.
Example written by our team for a fictional patient. Adapt it to your own patient's data. Build your statement with the PES generator.
Goals / expected outcomes
Written in measurable terms: what, how much and by when.
- Patient explains in their own words what diabetes is and what insulin does within 48 hours.
- Patient demonstrates insulin administration without errors on two occasions before discharge.
- Patient names four symptoms of hypoglycemia and what to do about them before discharge.
- Patient records fingerstick glucose and insulin dose in a log for 7 days after discharge.
- Before discharge, family member identifies the warning signs and when to go to the emergency department.
Nursing interventions and rationales
| Intervention | Rationale |
|---|---|
| Ask what the patient knows and believes about their illness before explaining. | Lets you build on what they already know and correct misconceptions. |
| Use plain words, short sentences and only a few topics per session. | Too much information at once is not retained. |
| Spread teaching over several short sessions during the stay, not just on the day of discharge. | People learn better when they have time to practice and ask questions. |
| Demonstrate the technique and have the patient repeat it until they can do it without errors. | Watching and practicing reinforces skill learning. |
| At the end of each session, ask the patient to explain what they learned in their own words (teach-back method). | Confirms they understood, not just that they listened. |
| Provide written or picture-based materials adapted to their reading level and in their language. | Serves as a guide at home when questions come up. |
| Include the family member or caregiver in the sessions. | Many home care tasks are done by someone else. |
| Teach when the patient is not in pain or highly anxious. | Pain and distress block attention. |
| Document what was taught, how it was evaluated and what is still pending. | Prevents repetition or gaps between shifts. |
NOC outcomes and NIC interventions
Outcomes (NOC) and interventions (NIC) that published sources link to this diagnosis. Pick the ones that fit your patient.
NOC outcomes
- 1803Knowledge: Disease Process
- 1802Knowledge: Prescribed Diet
- 1855Knowledge: Healthy Lifestyle
NIC interventions
- 5614Teaching: Prescribed Diet
- 5616Teaching: Prescribed Medication
- 5618Teaching: Procedure/Treatment
- 5510Health Education
Linkages drawn from care plans published by health services, universities and nursing journals. Labels may vary depending on the NIC and NOC edition your facility uses.
Case study: Type 2 diabetes starting insulin
Patient. 52-year-old woman with an 8-year history of type 2 diabetes, hospitalized for hyperglycemia. Insulin has been prescribed and she is going home in 3 days.
Assessment
- Fingerstick glucose on admission 386 mg/dL; HbA1c 10.4%.
- Says diabetes "goes away if you stop eating sugar."
- On return demonstration with an insulin pen, she does not prime the needle and pulls it out as soon as she finishes injecting.
- Cannot identify any symptoms of hypoglycemia.
- States she would skip the insulin on days she does not eat.
- Has an elementary school education and prefers explanations with pictures.
- Lives with her daughter, who is with her at the hospital.
Nursing diagnosis
Inadequate Health Knowledge regarding insulin management related to information given in technical terms without supervised practice as evidenced by incorrect injection technique on return demonstration, inability to identify symptoms of hypoglycemia, and stating she would skip the dose when she does not eat, in a patient with type 2 diabetes (associated condition).
Goal
Within 72 hours, patient demonstrates insulin pen administration without errors and names four symptoms of hypoglycemia and what to do about them.
Interventions
- Three 15-minute sessions a day, with her daughter present.
- Insulin pen demonstration and supervised practice with every dose.
- Handout with pictures of hypoglycemia symptoms and the rule of 15: 15 g of sugar and recheck glucose after 15 minutes.
- Explanation of what to do on days she does not eat, according to her provider's instructions.
- Teach-back at the end of each session.
Evaluation
At 72 hours she administers insulin without errors on two occasions, names five symptoms of hypoglycemia and explains the rule of 15; her daughter confirms it. She still believes diabetes can be cured. The diagnosis remains active at discharge, focused on the chronic nature of the disease, with follow-up at the nursing clinic.
How it differs from similar diagnoses
- Readiness for enhanced health knowledge (00499): This is a health promotion diagnosis: the person already knows what they need and wants to learn more. There is no deficit to correct.
- Ineffective health self-management (00276): The person knows what to do but cannot integrate it into daily life. If the problem is behavioral rather than informational, use the self-management diagnosis.
- Risk for ineffective blood glucose pattern self-management (00489): Focuses on the risk of blood glucose going out of range because of how the person manages their diabetes. It can coexist with this diagnosis.
Common mistakes
- Writing "Inadequate Health Knowledge related to lack of information": it restates the problem.
- Not specifying the topic: "regarding what" is part of the diagnosis.
- Marking the goal as met because the patient "says they understand," without having them explain or demonstrate it.
- Using it when the person knows what to do but chooses not to follow the treatment: that is a different problem.
- Still using code 00126 in assignments based on the 2024-2026 edition.
Used in these conditions
Other diagnoses in the Cognition class
Domain 5, Perception / cognition. See every diagnosis in this domain.
Frequently asked questions
What is the NANDA code for inadequate health knowledge?
00435. It belongs to Domain 5 (Perception/cognition), Class 4 (Cognition). It replaces Deficient Knowledge (00126).
What happened to the Deficient Knowledge nursing diagnosis?
In NANDA-I 2024-2026 its name and code changed: it is now Inadequate Health Knowledge (00435). If your nursing program uses the previous edition, you will see 00126.
Do I have to specify the topic?
Yes. Write what the knowledge gap is about: insulin, diet, inhaler use. That keeps the teaching plan clear.
How do I know the patient actually learned?
Ask them to explain it in their own words and to do a return demonstration of the technique. If they do it without errors on two occasions, you can consider the goal met.
How is it different from Readiness for Enhanced Health Knowledge?
00499 is used when the person has no deficit and wants to learn more. 00435 requires that they are missing information or have it wrong.
Study material: the explanation, characteristics, factors, examples and case study on this page were written by our editorial team. The official text for Inadequate health knowledge (00435) is in NANDA International Nursing Diagnoses: Definitions and Classification 2024-2026. This page does not replace clinical judgment or your facility's protocols.
Classification sources: NANDA-I 2024-2026, Thieme supplement · Elsevier summary of changes · Spanish edition table of contents · NOC/NIC: source 1. Reviewed November 2, 2026.